Kenya

Located in East Africa, bordering the Indian Ocean between Somalia and Tanzania, Kenya has a total territory of 582,650sq km situated almost equally above and below the Equator. In 2004, the estimated population was 32 million, though with a declining fertility rate, and an increasing mortality rate due to AIDS-related deaths. Tuberculosis and malaria also threaten the public health.

According to the World Health Organization, Kenya ranks tenth among the world’s top 22 countries with a high tuberculosis burden. Past successes in TB control have been hampered by the spread of HIV infection, putting an additional strain on the country’s health systems. As HIV weakens the immune system, opportunistic diseases are much more likely to invade the body causing further complications and leading to an increasing number of co-infections. TB remains the most common opportunistic infection and the most common cause of death in HIV-infected individuals and AIDS patients. In addition, drug-resistant strains of TB are appearing, making the disease that much more difficult and expensive to treat.

Poverty still remains a problem throughout the country, especially in the rural communities where many Kenyans still lack access to basic healthcare or good quality essential medicines, including anti-TB drugs. In June 2005, USP DQI assessed Kenya’s drug quality assurance program and control system focusing particularly on anti-TB medicines. In line with both Kenya’s national health objectives and USAID’s commitment to reduce the impact of infectious diseases in Kenya, USP DQI drug quality experts identified the strengths, weaknesses, and regulatory and technical gaps of Kenya’s system. Based on those findings, suggestions were made to USAID on how USP DQI might be able to assist national authorities strengthen their existing drug quality control systems at the national and program levels for anti-TB medicines and drugs for other priority diseases.

During its assessment, USP DQI noted a disparity in the access to quality information. While the Drug Information Center (DIC) at the Kenyatta National Hospital (KNH) is active and coordinates closely with the Pharmacy and Poison Board (PPB) of Kenya on medicines information, there is very limited access to critical drug information at the peripheral levels where the majority of the patients are seen and treated. The PPB’s efforts to set up the much-needed functional central drug information system have been challenged by the lack of both human and financial resources. Consequently, USP DQI is assisting Kenya to expand and develop its drug information centers, particularly at the referral hospital level. In addition to being the largest referral hospital in East and Central Africa, KNH works closely with PPB to support medicine information. Support directed to KNH and its close network of auxiliary hospitals is expected to lead to stronger medicine information in East and Central Kenya, establishing a sound, comprehensive, dependable, and functional system that responds effectively to improve patient outcomes. Among other objectives, Kenya DICs expect to provide reliable, up-to-date, unbiased information on medicines and their rational use; develop, disseminate, and implement medicine information literature for health professionals, patients, and consumers; participate in the activities of its national pharmacy and Drug Therapeutics Committee; and become even more responsive to PPB by providing a wide range of medical experts’ opinions on specific requests for evaluation and review of applications for drug registration submitted by the pharmaceutical industry.